Saturday, September 26, 2015

Gynecologist or Infertility Specialist?- It Isn’t a Coin Toss

Most infertile couples are confused about whom they should visit when they require medical assistance. It’s true that both the man and the woman get affected by infertility, but it’s typically the woman who is proactive with seeking medical care. Most bypass their family doctor, but they aren’t too sure about whether they should consult a gynecologist or an infertility specialist.

There are certain advantages and disadvantages to both these options and its worth looking at what these are.

The Logical Choice

The first logical choice is obviously the gynecologist and most women also have a long-standing relationship with him and are more comfortable with approaching him. Since these specialists tackle women’s health problems, most of them are competent enough to quickly recognize when infertility is the issue. However , they are very conservative in their approach and are typically the first choice for a simple problem, however:

•When it comes to dealing with any complex infertility issues, they have neither the knowledge not the skill to provide the right advice or treatment
•Since they are out of their depth, they tend to subject the patient to different and totally unnecessary surgical procedures such as laparoscopy
•When they are dealing with men with low sperm counts, they will perform IUI (Intrauterine Inseminations), simply because that is the extent of their skill
•They are also completely lost when it comes to handling male infertility problems and these patients will automatically be referred to a urologist . This also means that your care gets fragmented and results in being of poor quality
•Another major issue is that most gynecologists aren’t sufficiently aggressive while dealing with older women. Since a majority of their patients are fertile, they fail to keep in view the fact that age impacts the ovarian reserves of older women and can lead to infertility
•Apart from this, they aren’t particularly interested in treating infertility
•Their waiting rooms aren’t really infertile-patient friendly. There will be many expectant mothers and this is definitely a distress point for the infertile women who have come to consult the gynecologist
•Many of these specialists aren’t even empathetic or compassionate enough when they are dealing with infertile patients; they fail to see the emotional impact that infertility has on them

If you have a complex problem, an infertility specialist should be your first choice- they are experienced and have the expertise to deal with infertility, and will solve most of the problems with the use of advanced reproductive technology. But the other fact to keep in view, is that they are also quite expensive; some of them will also include complex, and unnecessary treatment that is very expensive, even when it isn’t warranted. All these aspects leave patients in a quandary and they aren’t at all sure which specialist they should approach.

What we do in our Clinic

•If I’m the first doctor the infertile couple is consulting, I complete the workup for them- this gives us an idea about what is causing the infertility
•This takes 7 days to complete and costs around Rs 6000 only
•In case the problem is a simple one, we recommend they consult a gynecologist for their treatment.
•This allows us to focus on infertile couples with complex problems and the quality of care we provide isn’t diluted in any way

Take Control of Your Treatment

In an ideal world, gynecologists should be taking care of all the simple problems; in case the couple fails to achieve a pregnancy within 6 months, they would then refer these patients to an infertility specialist. But that’s not how things typically work. Since most doctors have a proprietary attitude towards their patients , they are reluctant to refer these patients to infertility specialists; after all which doctor in his right mind would want to lose his patient?

But the patient is the one who stands to lose- money, time and energy ! One useful tip is to create a clear plan of action with a well defined timeframe in partnership with your doctor. This will give you a very clear idea about what your treatment options are; it will help you hold the reins of your medical treatments as well as your life, and it gives you peace of mind that you have done your best.